Provider Demographics
NPI:1811988645
Name:SISTERS OF PROVIDENCE CARE CENTERS INC.
Entity type:Organization
Organization Name:SISTERS OF PROVIDENCE CARE CENTERS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MCLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-539-2917
Mailing Address - Street 1:320 PITTSFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LENOX
Mailing Address - State:MA
Mailing Address - Zip Code:01240-2377
Mailing Address - Country:US
Mailing Address - Phone:413-637-2660
Mailing Address - Fax:413-637-3085
Practice Address - Street 1:320 PITTSFIELD RD
Practice Address - Street 2:
Practice Address - City:LENOX
Practice Address - State:MA
Practice Address - Zip Code:01240-2377
Practice Address - Country:US
Practice Address - Phone:413-637-2660
Practice Address - Fax:413-637-3085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-01
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0021314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0021OtherSTATE NURSING HOME LICENS
MA0924229Medicaid
MA225581Medicare Oscar/Certification